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Health Law and Policy Update

Headlines of the week

Medicaid FMAP
Before adjourning for the Memorial Day recess, the House of Representatives passed a scaled down version of a House-Senate compromise on H. R. 4213-the bill that extended unemployment benefits. The bill passed by the House dropped provisions to extend the American Recovery and Reinvestment Act (ARRA) Medicaid Federal Medical Assistance Percentages (FMAP) and COBRA benefits for two additional quarters (January 1, 2011 thru June 30, 2011). On June 8, 2010 the Senate Finance committee released an amendment that adds back the FMAP extension. The Senate Finance committee will begin deliberations on the amendment this week. Colorado will receive $211.7 million of additional Medicaid FMAP funds if this amendment is adopted. Or put another way, Colorado will have to cut another $211.7 million from the FY 2010/11 state budget if the FMAP amendment is not adopted.

The additional FMAP funds were part of the initial ARRA legislation and are due to end on December 31, 2010 if the amendment is not adopted. In February 2010 the National Governor's Association sent a letter signed by governors from 42 states to the Senate and House leadership urging them to extend the Medicaid FMAP funds for two more quarters.

COBRA
Congress failed to extend the measures providing extra weeks of unemployment insurance and subsidized COBRA health insurance coverage. ARRA, which passed in 2009, provided a federal subsidy to help pay for COBRA health insurance benefits for workers who were laid off between September 2008 and December 2009. Since then, Congress temporarily extended the COBRA subsidies and they remained available for workers who were laid off through May 31, 2010. On June 1, 2010 the subsidy expired and the newly unemployed are not eligible to get the subsidy. A proposal to extend subsidies to those laid off through the end of the year is languishing in Congress.

According to Families USA the average monthly COBRA premium in Colorado without the subsidy is $1,076 while the COBRA premium in Colorado with the subsidy is $376.

At the same time that Congress reduced the Medicaid FMAP federal assistance to the states, they did not extend the COBRA subsidies for newly laid off employees.

The failure to extend COBRA subsidies, combined with a reduction in state Medicaid FMAP assistance will have very significant consequences for people with the greatest need for health coverage assistance.

60,000 Coloradans are in the Medicare "Donut Hole"
Check the mail for a $250 check from the federal government if you are a Medicare customer that has entered the "donut hole". Medicare beneficiaries with limited or fixed incomes and who pay out-of -pocket for costly medication while they are in the donut hole will find the extra funds very valuable. About 60,000 Coloradans will receive the $250 check. The checks are the first step to closing the donut hole. In 2011 healthcare reform creates a drug discount program that will eliminate the donut hole completely by 2020.

The checks will be mailed by the Department of Health and Human Services (HHS) and the HHS logo will be clearly displayed on the envelope. The checks will be mailed by one of Medicare's contractors and will include the contractor's Wisconsin address.

High Risk Pool
In a letter dated May 27, 2010 to Secretary of HHS Kathleen Sebelius, Governor Bill Ritter, Jr. recommended Rocky Mountain Health Plan as the designated entity that will enter into a contract with HHS to operate the high risk pool for Coloradans that have pre-existing health conditions and have been uninsured for at least six months. CoverColorado, the current high risk pool, will continue operations for the 11,000 individuals enrolled.

It is expected that the state will receive HHS approval to proceed in early July 2010, and the new high risk pool will start enrollment by August or September.

What you can do

Contact Colorado Senators Mark Udall and Michael Bennet and urge them to extend FMAP.
Click the links above or call them:
Senator Mark Udall - 877-768-3255
Senator Michael Bennet - 202-224-5852

Schedule a presentation on health reform
Health reform can be confusing. The health staff at the Colorado Center on Law and Policy is ready to help community groups, medical professionals, lawmakers and others understand the complexities of health reform and how it will roll out during the next few years. Please contact us to schedule a presentation.

Health Law and Policy Update is issued weekly by the health staff of the Colorado Center on Law and Policy. Subscribe by e-mail or read previous editions.

Health Care Director
Elisabeth Arenales

Health Care Attorney
Adela Flores-Brennan

Special Counsel
Ed Kahn

Communications Director
Perry Swanson

Released June 10, 2010